Nikolay Lunchenkov is an infectious diseases doctor and reseacher. He worked as public health expert for several years in Global leading organizations. He currently serves as a LGBT health coordinator in ECOM. The main research interest belongs to sexual health, PrEP and substance use among gay men and bisexual men.

COVID-19 pandemic dramatically impacts the health and substance use of different populations, including lesbian, gay, bisexual, transgender and others (LGBTQI+). Social policies and the general atmosphere in Eastern Europe and Central Asia (EECA) tend to be homophobic and discriminative, leading to the exclusion of individuals from social protection programs. Importantly, strategic information about the impact of COVID-19 in the region is limited. The study aimed to identify the association between financial insecurity and substance use during the last six months of the pandemic.

Data were collected from "The impact of COVID-19 online survey" conducted in June - August 2022 in Kazakhstan, Kyrgyzstan, Armenia and Georgia. The survey included information regarding their socio-demographics, economic outcomes, and changes in substance use. Multivariate logistic regression was applied to identify association between substance use and economic outcomes.

The total number of eligible participants (n=914), included respondents from Armenia (n=120), Georgia (n=256), Kazakhstan (n=140) and Kyrgyzstan (n=398). The average age was 26.4 years (SD = 6.8). 10.7% self-reported living with HIV, and 34.4% were diagnosed during the last six months. A quarter of the sample (26.1%) reported an increase in alcohol consumption and 6.4% in recreational drug use. In the multivariate model, adjusting to socio-demographics, increased alcohol consumption was associated with job losses and difficulties in buying food (AOR = 1.47, 95%CI: 1.05 - 1,88; AOR = 0.58, 95%CI: 0.13 - 1.03). The increase in recreational drug use was not associated with economic outcomes.

The study findings highlight the vulnerability of LGBTQI+ individuals caused by the COVID-19 pandemic. It adds to evidence that financial insecurity is associated with alcohol consumption. The results show importance of developing economic empowerment programs and increasing social protection. The increase in recreational drug use requires adjusting the existing HIV programmes and adapting services to the new challenges caused by COVID-19.